[Remote] Claims Examiner

Note: The job is a remote job and is open to candidates in USA. Allianz Partners is a global leader in insurance and asset management, committed to putting people first. As a Claims Examiner, you will review claims, determine coverage, and communicate outcomes to customers, ensuring timely and accurate service.

Responsibilities

• Review submitted claims to identify the incident, determine applicable coverage based on policy terms, and calculate eligible benefits for reimbursement
• Approve or deny claims in accordance with the terms and conditions of the insurance agreement
• Communicate claim outcomes to customers via letter, email, or phone once a decision has been reached
• Respond to incoming customer inquiries (phone or email) regarding claim status, documentation, or general information
• Accurately document claim determinations, notes, and actions in PeopleSoft following established guidelines
• Collaborate with internal departments to obtain or verify missing or unclear claim information
• Investigate inconsistencies and escalate complex or questionable claims to the Team Leader
• Send out claim forms to new customers as needed
• Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use

Skills

• High school diploma or equivalent required
• A strong desire to learn, grow, and build a long-term career with us
• Strong attention to detail and solid organizational skills
• Excellent written and verbal communication abilities
• Ability to work both independently and collaboratively within a team environment
• Previous claims processing experience is a plus but not required
• Familiarity with PeopleSoft or similar claims management systems is a plus

Benefits

• Health, dental, and vision insurance
• Retirement savings plans
• Paid time off
• Other employee programs

Company Overview

Company H1B Sponsorship